AMA on a Wednesday? This ish is about to get real! Moving from the extremely disjointed and fragmented medical system in Las Vegas to an intergrated one in Albuquerque has been eye opening. What struck me the most is the constant message that all 1000 providers in my medical group are all coworkers. We are all here for a singular purpose and we are encouraged to consider every provider in the group our co-worker, not just our immediate care team or speciality. It feels like we are all working together for one common goal.

Zubin - thanks for continuing your quest to profoundly innovate and impact our healthcare system. Keep the Beat! Rich O

I shared this with my sister who is an FNP in a hospital-owned primary care practice. The community hospital system was recently acquired by a larger metropolitan hospital system. I'm sure she'll find this thought provoking. Due to all of the frustrations she encounters daily, she's actually considering going back to floor nursing...fewer headaches, less responsibility, and more money!

Excellent discussion! Wow! So spot on. 40 plus yrs as a nurse in HC. He hits on all the thruths. Now is the time for the real change. Nursing plays such a huge role at the table along side all the HC professions. Keep nurses on the feild, at the bedside. We need to train the young, they need to enlighten us!Big props to Tom & Logan. Best support team with different views. Dogg U just continue to rock!

I saved this video to my KZfaq "Medical" favorites folder. It's worth watching again. I will read the book...good stuff!

Totally loved this interview! These two compliment each other so well! I loved the mutual respect and the thought provoking conversation! I learned so many things watching this show, and can't wait to read Dr. Pearl's book! I am so glad that I found ZDoggMD about 6 months ago! Every one of the videos that ZDogg does is so interesting and informative. Oh yeah, they are pretty funny, too! As I watch every show I think of so many topics that I would love to see ZDogg delve into. I wish there was somewhere I could list these topics as they come to my mind! Keep them coming Z and I'll keep watching and learning! Thanks!!

What an awesome honest informed and dare I say entertaining discussion about US healthcare. Integrated ,team-based, preventative, evidence-based and tech savvy healthcare is the common goal that we desperately need to serve the public and ourselves. I'm definitely going to read the book. Thanks for an enlightening hour plus dive into the troubled waters of US healthcare and what we can do to get where we should be!

I would love that video option! I have advanced COPD and I have begged my doctor not to book my appointments for med refills for the busiest hours and during flu and cold season. But inevitably I end up in a waiting room full of people sniffling and coughing with little kids running around touching everything! And I end up sick, and sometimes even in the hospital because of it. When all he did during my visit was ask how are you doing? Is your medicine still giving you relief? Etc. 5 minutes to endanger my health so that he can get paid for an office visit every 6 months? Does that make sense? Not to me. Not to mention the physical exertion and real cost to my well being, sometimes for days afterward. I know I'll probably never see the benefits of what you are trying to do. But I salute your efforts and hope you succeed in your cause. Both of you. Thank you.

Such great content man... this channel gave me so many insights into healthcare as a junior MD, thanks a lot zdogg

American healthcare is the best in the world for high earners who want to live forever.

Very thought provoking. Medicine needs to change.

Z you should stop saying "I'm so old". Was reading a paper earlier that basically said it conditions your brain to think you're old. Maybe start exclaiming how awesome and young you are!

I agree with his concepts about integrating healthcare. The Tele-medicine idea has some viable application in very simple visits (common cold, etc) but would open clinicians up for major lawsuits when something is missed that could cause a bad patient outcome. I've worked all over the country as an RN, including Stanford. The physician/resident culture and the RN culture was great there. Strangely, the APRN roles were starkly not represented when I worked there. The university doesn't even have a nursing program in any sense. In fact, I worked in IR with some anesthesiologists that let it be clear CRNAs were not welcome there. This was disheartening considering I was applying to CRNA school and felt highly respected and valued as a BSN at the facility. It became apparent that they were staunchly making a stand against CRNAs taking over "their" field. With 70% of anesthetics in rural America (the majority of America) being provided by CRNAs it didn't make sense to me to make a stand against something that's already been done. I believe he said his brother was an anesthesiologist at Stanford. Combine that with his best attempt at a PC way to respond to ZDogg when prompted about nurses being clinicians on the team, I lost respect for this guest. He had the opportunity to say the right thing and be a part of the future of healthcare but he side stepped it. Attempting to blame other physicians who would not allow change if APRNs were valued clinicians at the same level of the MD. Notice he didn't say that would be the wrong viewpoint and we should work to change that flawed thinking. Whoops, somebodies 1970's healthcare 1.0 hierarchy is showing.

My experience of Kaiser in Hawaii in 70s/80s--IT SUCKED.

My 26 year old daughter just died in a kiaser hospital by being drown with fluids in her bed in front of my face while we both begged for help. Her renal system was shut down by ungodly amounts of Vancomycin and Zosyn for a blood infection that the LAB disputed completely and Cdiff with no diarrhea or test result (plus other nephrotoxins) and a team of nurses grinding time release morphine into her feeding tube while she slept (I woke up and caught them). Viola - renal system shut down. then nonstop TPN nutrition and Lipids throughout the struggle to breathe....then knocked unconscious by two drugs she had never taken before, 50mcgs of fentanyl and an UNDISCLOSED amount of propofol (no concentration recorded) and then the fentanyl was escalated to 625 mcgs which killed her instantly. They told me she died of natural causes....then I read the records. My daughter wasn't terminally ill; I had no idea of all the narcotics she was getting that last day. These drowning episodes were constant and I would scream in the halls and she would be saved....until the last episode. I had to quit my job to stay by her side to monitor what drugs and fluids they were giving and then that last night... I dozed off. Their protocol system is broken. The fluid overload events were always called PNA and the struggle to breathe was always called an annoying PANIC ATTACK the patient needs psych drugs for....if you have someone in the hospital there check all the LABS before antibiotics yourself; don't believe the PANIC DISORDER diagnosis; it is used to ignore the suffering they are causing. Under California Microcap laws, death of patients is an attractive way to get out of liabilities. In life, an error disabling a young woman can be a HUGE liability; but if that patient dies that liability is automatically reduced to the $250k cap and with that cap there will most likely be no lawsuit at all because there is no money in it for the lawyer after medical expert costs. So do you think a profit seeking entity would keep you alive if it was going to cost them millions? Despite the Supreme Court ruling that corporations are people, they are NOT. Corporations have no soul...they simply seek profits brainlessly. Rewatch Andy Fastow in "the smartest guys in the room" he said he thought it was okay because nobody told him no and everyone wanted to be involved. All large corporation are by policy must put shareholders first. Get the profiteering out of healthcare!

A lot of personal adverse experiences with the Kaiser Permanente system would force me to be skeptical about Dr. Pearl's proposals to restructure the healthcare system. And I think technology, in the way he describes it, makes healthcare less personal. Just having systems that could effectively communicate with one another and solve the business/insurance side of healthcare to make it easier on patients would be a huge start. Telecare in the grand scheme of healthcare today doesn't matter dick to patients, for example. And yes, stop referring to patients as clients.

This was such a good conversation! I was able to view it live and I completely agree with everything!

I'd worry if I agreed with everything that was said. But I don't, so I'm not worried! Yay! But it IS thought provoking. Jingoism and health care can never be a good match with each other. I need to watch this again, and I will probably buy the book in Kindle format because my backpack weighs enough as it is!

It isn't anti-vaxxer logic, it is real logic ZDogg. My favorite part is 4 minutes in when ZDogg jokingly challenges him that it is the Kimchi that is the difference between the US and Korea. You will notice that Dr. Pearl immediately backs off and admits that his whole initial argument that it is a system problem why we suck compared to South Korea is faulty. It isn't the medical system that is the difference in outcomes between a country with a 34% obesity rate and a country with a 6% obesity rate. Perhaps other factors are at play.

Is this guy related to Christopher Walken?

YES, far more primary care PHYSICIANS (NOT NPs, NOT PAs, NOT CRNAs) far fewer specialists. More primary care physicians trained in REAL Preventative care, the time to do preventative care and proper reimbursement for preventative care. Tests for early detection is NOT preventative care.

This video triggered my PTSD. I worked for Kaiser in the Bay Area while Pearl was in charge for over nine years. Worst work environment ever. (Most physicians there had no other options because Kaiser was "the only game in town.") Huge turnover. Most slovenly healthcare provided to patients....ever. I suspect that Dr. Pearl will burn in hell for eternity but I'm not judging.